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https://www.readbyqxmd.com/read/28324822/outcome-evaluation-of-minimally-invasive-surgery-versus-extensile-lateral-approach-in-management-of-displaced-intra-articular-calcaneal-fractures-a-randomised-control-trial
#1
Ankit Khurana, Mandeep S Dhillon, Sharad Prabhakar, Rakesh John
BACKGROUND: Minimally invasive surgery has a significant and evolving role in the treatment of DIACFs, but there is limited literature on this topic. OBJECTIVES: To compare the clinico-radiological outcomes of DIACFs fixed with MIS technique with ORIF. METHODS: This randomised control trial (RCT) included 21 closed Sanders type 2 and 3 DIACFs which were selected from 70 who presented. Extensile lateral approach was used in the ORIF group; while MIS techniques included either percutaneous reduction or small incisions with indirect fragment manipulation...
February 20, 2017: Foot
https://www.readbyqxmd.com/read/28323838/bupropion-for-the-treatment-of-apathy-in-huntington-s-disease-a-multicenter-randomised-double-blind-placebo-controlled-prospective-crossover-trial
#2
Harald Gelderblom, Torsten Wüstenberg, Tim McLean, Lisanne Mütze, Wilhelm Fischer, Carsten Saft, Rainer Hoffmann, Sigurd Süssmuth, Peter Schlattmann, Erik van Duijn, Bernhard Landwehrmeyer, Josef Priller
OBJECTIVE: To evaluate the efficacy and safety of bupropion in the treatment of apathy in Huntington's disease (HD). METHODS: In this phase 2b multicentre, double-blind, placebo-controlled crossover trial, individuals with HD and clinical signs of apathy according to the Structured Clinical Interview for Apathy-Dementia (SCIA-D), but not depression (n = 40) were randomized to receive either bupropion 150/300mg or placebo daily for 10 weeks. The primary outcome parameter was a significant change of the Apathy Evaluation Scale (AES) score after ten weeks of treatment as judged by an informant (AES-I) living in close proximity with the study participant...
2017: PloS One
https://www.readbyqxmd.com/read/28319423/silexan-does-not-cause-withdrawal-symptoms-even-when-abruptly-discontinued
#3
M Gastpar, W E Müller, H P Volz, H J Möller, S Schläfke, A Dienel, S Kasper
OBJECTIVE: Subsequent to a randomised, double-blind, double dummy clinical trial assessing the efficacy of silexan compared to placebo and paroxetine in patients suffering from generalised anxiety disorder (GAD), a 1week follow-up phase was added in order to assess possible withdrawal symptoms of silexan after abrupt discontinuation. METHODS: Participants received silexan 80 mg/d, silexan 160 mg/d, paroxetine 20 mg/d, or placebo at a ratio of 1:1:1:1. Study medication was discontinued after the 10 week active treatment phase of the original trial...
March 20, 2017: International Journal of Psychiatry in Clinical Practice
https://www.readbyqxmd.com/read/28319269/withdrawn-trimetazidine-for-stable-angina
#4
REVIEW
Agustín Ciapponi, Rudolf Pizarro, Jeff Harrison
BACKGROUND: Patients with stable angina not controlled by monotherapy with nitrates, beta blockers, or calcium channel blockers are often treated with combinations of these drugs. There may be adverse effects from, or contraindications to, the use of combinations. In low risk groups, medical treatment appears to be as good an option as percutaneous transluminal coronary angioplasty in terms of averting myocardial infarction, death, or subsequent revascularization. Revascularization procedures are too costly or inaccessible for many patients in developing countries therefore effective and safe medical treatment is needed...
March 20, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28319266/benzodiazepines-for-restless-legs-syndrome
#5
REVIEW
Karla Carlos, Gilmar F Prado, Camila Dm Teixeira, Cristiane Conti, Marcio M de Oliveira, Lucila Bf Prado, Luciane Bc Carvalho
BACKGROUND: Restless legs syndrome (RLS) is a common disease affecting about 5% to 15% of the population. Symptoms of RLS can be severe in a minority of and can have a major impact on sleep, mostly sleep initiation, and quality of life. Benzodiazepines are drugs that can induce and maintain sleep and, hence, intuitively are thought to be beneficial to people with RLS. Altough benzodiazepines, particularly clonazepam, are used to treat RLS symptoms, a systematic review done by the American Academy of Sleep Medicine stated that benzodiazepines should not be used as a first-line treatment, although could be used as a coadjuvant therapy...
March 20, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28319248/cyclic-tensile-strain-enhances-human-mesenchymal-stem-cell-smad-2-3-activation-and-tenogenic-differentiation-in-anisotropic-collagen-glycosaminoglycan-scaffolds
#6
W G Grier, A S Moy, B A Harley
Stem cell research arose from the need to explore new therapeutic possibilities for intractable and lethal diseases. Although musculoskeletal disorders are basically nonlethal, their high prevalence and relative ease of performing clinical trials have facilitated the clinical application of stem cells in this field. However, few reliable clinical studies have been published, despite the plethora of in vitro and preclinical studies in stem cell research for regenerative medicine in the musculoskeletal system...
March 20, 2017: European Cells & Materials
https://www.readbyqxmd.com/read/28318984/safety-and-efficacy-of-thrombectomy-in-acute-ischaemic-stroke-revascat-1-year-follow-up-of-a-randomised-open-label-trial
#7
Antoni Dávalos, Erik Cobo, Carlos A Molina, Angel Chamorro, M Angeles de Miquel, Luis San Román, Joaquín Serena, Elena López-Cancio, Marc Ribó, Mónica Millán, Xabier Urra, Pere Cardona, Alejandro Tomasello, Carlos Castaño, Jordi Blasco, Lucía Aja, Marta Rubiera, Meritxell Gomis, Arturo Renú, Blanca Lara, Joan Martí-Fàbregas, Brian Jankowitz, Neus Cerdà, Tudor G Jovin
BACKGROUND: The REVASCAT trial and other studies have shown that the neurovascular thrombectomy improves outcomes at 90 days post stroke. However, whether the observed benefit is sustained in the long term remains unknown. We report the results of the prespecified 12-month analysis of the REVASCAT trial. METHODS: Patients with acute ischaemic stroke who could be treated within 8 h of symptom onset were randomly assigned to medical therapy (including intravenous alteplase when eligible) and neurovascular thrombectomy with Solitaire FR or medical therapy alone...
March 16, 2017: Lancet Neurology
https://www.readbyqxmd.com/read/28318766/bacille-calmette-gu%C3%A3-rin-bcg-vaccination-at-birth-and-antibody-responses-to-childhood-vaccines-a-randomised-clinical-trial
#8
Thomas Nørrelykke Nissen, Nina Marie Birk, Gaby Smits, Dorthe Lisbeth Jeppesen, Lone Graff Stensballe, Mihai G Netea, Fiona van der Klis, Christine Stabell Benn, Ole Pryds
INTRODUCTION: BCG vaccination has been associated with beneficial non-specific effects on child health. Some immunological studies have reported heterologous effects of vaccines on antibody responses to heterologous vaccines. Within a randomised clinical trial of Bacille Calmette-Guérin (BCG) vaccination at birth, The Danish Calmette Study, we investigated the effect of BCG at birth on the antibody response to the three routine vaccines against DiTeKiPol/Act-Hib and Prevenar 13 in a subgroup of participants...
March 15, 2017: Vaccine
https://www.readbyqxmd.com/read/28318619/effect-on-the-lipid-parameters-of-an-intervention-to-reduce-weight-in-overweight-and-obese-patients
#9
M Loreto Tárraga Marcos, Josefa María Panisello Royo, Julio A Carbayo Herencia, Nuria Rosich Domenech, Josep Alins Presas, Pedro J Tárraga López
OBJECTIVE: To assess the effect on lipid parameters most associated with excess weight (triglycerides [TG], cholesterol, and high density lipoprotein [HDL-C]) of an intervention to reduce weight in overweight and obese patients. METHODS: A randomised, controlled, double blind clinical trial, with three groups, and a follow-up of 12 months. Patients included in the study were randomised into three intervention groups: Obesity motivational intervention group with previously trained nurse (G1), lower intensity consultation, non-motivational group, with digital platform support (G2), and a third group that received a recommendation to lose weight and usual follow-up (G3)...
March 16, 2017: Clínica e Investigación en Arteriosclerosis
https://www.readbyqxmd.com/read/28318076/uk-policy-statements-on-testosterone-deficiency
#10
Geoffrey Hackett, Michael Kirby, David Edwards, T Hugh Jones, Jonathan Rees, Asif Muneer
To address widespread media and scientific concerns over the appropriate treatment of TDS with Testosterone Therapy (T Therapy), the Executive Committee of the British Society for Sexual Medicine developed eight consensus statements, based on current scientific evidence to address these controversial issues. These statements were in no-way designed to replace the published evidence-based guidelines on the subject developed by various professional organisations, but to provide specific answers to several current controversial issues...
March 20, 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28317094/long-term-outcomes-and-cost-effectiveness-of-high-dose-dexamethasone-for-cardiac-surgery-a-randomised-trial
#11
J M Dieleman, G A de Wit, A P Nierich, P M Rosseel, J M van der Maaten, J Hofland, J C Diephuis, F de Lange, C Boer, R E Neslo, K G Moons, L A van Herwerden, J G Tijssen, C J Kalkman, D van Dijk
Prophylactic intra-operative administration of dexamethasone may improve short-term clinical outcomes in cardiac surgical patients. The purpose of this study was to evaluate long-term clinical outcomes and cost effectiveness of dexamethasone versus placebo. Patients included in the multicentre, randomised, double-blind, placebo-controlled DExamethasone for Cardiac Surgery (DECS) trial were followed up for 12 months after their cardiac surgical procedure. In the DECS trial, patients received a single intra-operative dose of dexamethasone 1 mg...
March 20, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28316007/talimogene-laherparepvec-for-treating-metastatic-melanoma-an-evidence-review-group-perspective-of-a-nice-single-technology-appraisal
#12
REVIEW
Nigel Fleeman, Adrian Bagust, Angela Boland, Sophie Beale, Marty Richardson, Ashma Krishan, Angela Stainthorpe, Ahmed Abdulla, Eleanor Kotas, Lindsay Banks, Miranda Payne
The National Institute for Health and Care Excellence (NICE) invited the manufacturer (Amgen) of talimogene laherparepvec (T-VEC) to submit clinical and cost-effectiveness evidence for previously untreated advanced (unresectable or metastatic) melanoma as part of the Institute's Single Technology Appraisal process. The Liverpool Reviews and Implementation Group (LRiG) at the University of Liverpool was commissioned to act as the Evidence Review Group (ERG). This article presents a summary of the company's submission of T-VEC, the ERG review and the resulting NICE guidance (TA410), issued in September 2016...
March 18, 2017: PharmacoEconomics
https://www.readbyqxmd.com/read/28315833/predictive-factors-for-the-placebo-effect-in-clinical-trials-for-dry-eye-a-pooled-analysis-of-three-clinical-trials
#13
Takahiro Imanaka, Izumi Sato, Shiro Tanaka, Koji Kawakami
BACKGROUND: Placebo effect is one of the methodological difficulties in dry eye clinical trials. If we could elucidate the tendencies of the placebo response and find predictors, we could reduce the placebo response in clinical trials for dry eye. In this study, we investigated the predictive factors for the placebo effect in dry eye clinical trials. METHODS: A total of 205 patients with dry eye assigned to the placebo arms of three placebo-controlled randomised clinical trials were analysed by simple and multivariable regression analysis...
March 18, 2017: British Journal of Ophthalmology
https://www.readbyqxmd.com/read/28315575/systematic-review-on-the-cost-effectiveness-of-self-management-education-programme-for-type-2-diabetes-mellitus
#14
REVIEW
J X Lian, S M McGhee, J Chau, Carlos K H Wong, Cindy L K Lam, William C W Wong
OBJECTIVES: A review of cost-effectiveness studies on self-management education programmes for Type 2 diabetes mellitus. METHODS: Cochrane, PubMed and PsycINFO databases were searched for papers published from January 2003 through September 2015. Further hand searching using the reference lists of included papers was carried out. RESULTS: In total, 777 papers were identified and 12 papers were finally included. We found eight programmes whose effectiveness analyses were based on randomised controlled trials and whose costs were comprehensively estimated from the stated perspective...
February 22, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28314755/a-randomised-controlled-trial-of-the-efficacy-and-safety-of-allopurinol-dose-escalation-to-achieve-target-serum-urate-in-people-with-gout
#15
Lisa K Stamp, Peter T Chapman, Murray L Barclay, Anne Horne, Christopher Frampton, Paul Tan, Jill Drake, Nicola Dalbeth
OBJECTIVES: To determine the efficacy and safety of allopurinol dose escalation using a treat-to-target serum urate (SU) approach. METHODS: A randomised, controlled, parallel-group, comparative clinical trial was undertaken. People with gout receiving at least creatinine clearance (CrCL)-based allopurinol dose for ≥1 month and SU ≥6 mg/dL were recruited. Participants were randomised to continue current dose (control) or allopurinol dose escalation for 12 months...
March 17, 2017: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/28314744/randomised-controlled-trial-comparing-ofatumumab-to-rituximab-in-children-with-steroid-dependent-and-calcineurin-inhibitor-dependent-idiopathic-nephrotic-syndrome-study-protocol
#16
Pietro Ravani, Alice Bonanni, Gian Marco Ghiggeri
INTRODUCTION: Oral steroids induce remission in about 90% of children with idiopathic nephrotic syndrome (INS), which is characterised by severe proteinuria and hypoalbuminaemia. Some children become steroid-dependent (SD) and require addition of calcineurin inhibitors (CNI) to maintain remission. Since these oral agents are toxic, alternative interventions are needed for long-term treatment. The anti-CD20 antibody rituximab has shown promising steroid-sparing properties in clinical trials, but benefits are less convincing in complicated forms of SD-INS...
March 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28314743/adjunctive-clindamycin-for-cellulitis-a-clinical-trial-comparing-flucloxacillin-with-or-without-clindamycin-for-the-treatment-of-limb-cellulitis
#17
Richard Brindle, O Martin Williams, Paul Davies, Tim Harris, Heather Jarman, Alastair D Hay, Peter Featherstone
OBJECTIVE: To compare flucloxacillin with clindamycin to flucloxacillin alone for the treatment of limb cellulitis. DESIGN: Parallel, double-blinded, randomised controlled trial. SETTING: Emergency department attendances and general practice referrals within 20 hospitals in England. INTERVENTIONS: Flucloxacillin, at a minimum of 500 mg 4 times per day for 5 days, with clindamycin 300 mg 4 times per day for 2 days given orally versus flucloxacillin given alone...
March 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28314731/long-term-outcomes-of-provisional-stenting-compared-with-a-two-stent-strategy-for-bifurcation-lesions-a-meta-analysis-of-randomised-trials
#18
Ramez Nairooz, Marwan Saad, Islam Y Elgendy, Ahmed N Mahmoud, Fuad Habash, Partha Sardar, David Anderson, David M Shavelle, J Dawn Abbott
BACKGROUND: The optimal interventional technique for addressing coronary bifurcation lesions is debatable. Long-term clinical outcomes with provisional stenting (PS) compared with a two-stent (TS) strategy for bifurcation lesions are scarce. We aim to perform the first meta-analysis of randomised controlled trials (RCTs) to explore long-term outcomes comparing both strategies. METHODS: An electronic search was performed for online databases until August 2016 for RCTs comparing PS with TS for bifurcation lesions reporting outcomes at 1 year of follow-up or more...
March 17, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28306591/ventilation-with-high-versus-low-peep-levels-during-general-anaesthesia-for-open-abdominal-surgery-does-not-affect-postoperative-spirometry-a-randomised-clinical-trial
#19
Tanja A Treschan, Maximilian Schaefer, Johann Kemper, Bea Bastin, Peter Kienbaum, Benedikt Pannen, Sabrine N Hemmes, Marcelo G de Abreu, Paolo Pelosi, Marcus J Schultz
BACKGROUND: Invasive mechanical ventilation during general anaesthesia for surgery typically causes atelectasis and impairs postoperative lung function. OBJECTIVE: We investigated the effect of intraoperative ventilation with high positive end-expiratory pressure (PEEP) and recruitment manoeuvres (RMs) on postoperative spirometry. DESIGN: This was a preplanned, single-centre substudy of an international multicentre randomised controlled trial, the PROVHILO trial...
March 16, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28304205/stenting-of-the-cervical-internal-carotid-artery-in-acute-stroke-management-the-karolinska-experience
#20
Anastasios Mpotsaris, Christoph Kabbasch, Jan Borggrefe, Vamsi Gontu, Michael Soderman
Background Emergency stent placement in the extracranial internal carotid artery in combination with anterior circulation thrombectomy is a routine procedure. Yet, precise indications and clinical safety in this setting remains controversial. Present data for mechanical thrombectomy include few studies with acute stenting of tandem occlusions. We evaluated the feasibility, safety and clinical outcome of this endovascular treatment in a retrospective analysis of all consecutive cases at a comprehensive stroke centre...
April 2017: Interventional Neuroradiology
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